title: Long-term outcome of correction of tetralogy of Fallot in 56 adult patients.
abstract: BACKGROUND
  Although most patients with tetralogy of Fallot undergo radical repair during infancy and childhood, patients that remain undiagnosed and untreated until adulthood can still be treated. This study aimed to evaluate longterm outcomes of adult patients with tetralogy of Fallot who were treated surgically, and to determine the predictors of postoperative pulmonary regurgitation.
  
  
  METHODS
  Fifty-six adult patients underwent complete surgical repair. Forty-three patients (76.8%) required a transannular patch. Systolic, diastolic, and mean pressure in the main pulmonary artery were measured after repair.
  
  
  RESULTS
  The early mortality rate was 3.6%. The 16-year survival rate was (84.4 ± 11.5)%. Late echocardiography revealed 41 patients with transannular patch who had pulmonary regurgitation, consisting of mild pulmonary regurgitation in 28 patients, moderate in eight, and severe regurgitation in five patients. In addition, there was right ventricular outflow tract stenosis in nine patients, moderate/severe tricuspid valve regurgitation in seven, and residual ventricular septal defect in five. Logistic regression analysis demonstrated that the mean pulmonary pressure measured just after repair predicted late pulmonary regurgitation.
  
  
  CONCLUSIONS
  The long-term survival of surgically treated adult patients with tetralogy of Fallot is acceptable. The mean pressure >20 mmHg in the main pulmonary artery measured right after surgical repair may be a feasible reference to time the reconstruction of the pulmonary valve.
authors.affiliation: Department of Cardiothoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China; Department of Cardiothoracic Surgery, Ningbo Medical Centre Lihuili Hospital, Ningbo, Zhejiang 315041, China.
authors.forename: Da-wei
authors.initials: DW
authors.lastname: Zheng
authors.forename: Guo-feng
authors.initials: GF
authors.lastname: Shao
authors.forename: Qiang
authors.initials: Q
authors.lastname: Feng
authors.forename: Yi-ming
authors.initials: YM
authors.lastname: Ni
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011651:Pulmonary Artery / Q000503:physiopathology; D011665:Pulmonary Valve Insufficiency / Q000209:etiology; D015996:Survival Rate; D013771:Tetralogy of Fallot / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome